2022-05-14T09:56:48-05:00 2021-06-30 861065772 DELOITTE TAX LLP 50 SOUTH SIXTH STREET MINNEAPOLIS MN 55402 990 2020-07-01 452438973 CENTRACARE HEALTH SYSTEM - SAUK CENTRE CENT 3203522221 425 N ELM ST SAUK CENTRE MN 56378 JOSEPH KALKMAN EVP, CAO & CHRO 3203522221 2022-05-10 1 JOSEPH KALKMAN 999009999 CHRIS MESKIMEN P01314196 6123974000 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z CENTRACARE HEALTH - SAUK CENTRE DR KENNETH HOLMEN 425 N ELM ST SAUK CENTRE MN 56378 39054768 0 X WWW.CENTRACARE.COM X 2011 MN WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. 15 9 0 10 0 0 3141250 -167793 35259515 36365707 1391452 2010197 960877 687905 40753094 38896016 122987 8335 0 0 18597103 20976239 0 0 0 13497525 15734828 32217615 36719402 8535479 2176614 54373627 63807230 21361905 24026930 33011722 39780300 WE'RE HERE FOR YOUR WHOLE LIFE TO LISTEN, THEN SERVE, TO GUIDE AND HEAL BECAUSE HEALTH MEANS EVERYTHING. 0 0 16708922 8335 23549461 CCH - SAUK CENTRE IS PART OF A LARGER INTEGRATED HEALTH CARE DELIVERY SYSTEM KNOWN AS CENTRACARE HEALTH, A SYSTEM RECOGNIZED FOR BEING A LEADER IN PROVIDING HIGH-QUALITY, COMPREHENSIVE CARE THROUGHOUT THE REGION. CCH - SAUK CENTRE IS A 25 BED CRITICAL ACCESS HOSPITAL THAT PROVIDES ACUTE CARE SERVICES IN THE AREAS OF MEDICAL, SURGICAL, DIAGNOSTIC AND OBSTETRICS ALONG WITH OTHER SERVICES OF 24 HOUR EMERGENCY ROOM, IMAGING, LABORATORY, REHABILITATION, AND CHEMOTHERAPY TO THE COMMUNITY OF STEARNS COUNTY. DURING FISCAL YEAR 2021 THERE WERE 572 INPATIENT VISITS, 2,172 INPATIENT DAYS WITH 34,076 OUTPATIENT VISITS. 10831434 12821382 CCH - SAUK CENTRE OPERATES THE SAUK CENTRE CLINIC, SAUK CENTRE LAKESHORE ESTATES, AND SAUK CENTRE CARE CENTER, WHICH ARE ALL CONVENIENTLY CONNECTED TO THE SAUK CENTRE HOSPITAL FOR THE HEALTH NEEDS OF THE COMMUNITY. SAUK CENTRE CLINIC PROVIDES SERVICES OF GENERAL SURGERY, NEUROLOGY, OBSTETRICS/GYNECOLOGY, ONCOLOGY, ORTHOPEDICS, AND UROLOGY. THERE WERE 19,673 CLINIC VISITS DURING FISCAL YEAR 2021. SAUK CENTRE LAKESHORE ESTATES IS A 30-UNIT INDEPENDENT LIVING SENIOR HOUSING APARTMENT BUILDING THAT OFFERS RETIREMENT LIVING AT ITS FINEST. SAUK CENTER CARE CENTER IS A 60 BED SKILLED NURSING FACILITY WITH 16,562 RESIDENT DAYS OF CARE FOR FISCAL 2021. 27540356 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 MN X ADAM PAULSON 3203522221 425 N ELM ST SAUK CENTRE MN 56378 KENNETH D HOLMEN MD PRESIDENT/CEO 6.50 33.50 X X 0 1423120 42559 DONALD JURGENS MD DIRECTOR 1.00 39.00 X 0 863168 20730 CHRISTIAN P SCHMIDT MD DIRECTOR 1.00 39.00 X 0 514228 73374 RICHARD A WEHSELER MD DIRECTOR 1.00 39.00 X 0 403754 58681 BRYAN ROLPH MD DIRECTOR 1.00 39.00 X 0 431949 1783 SHARON J RUGGIERO MD DIRECTOR 1.00 39.00 X 0 260991 57886 DAVID ANFINSON VICE CHAIR 0.25 1.75 X X 0 0 0 STEVE LARAWAY BOARD CHAIR 0.25 1.75 X X 0 0 0 BOB THUERINGER DIRECTOR 0.20 1.80 X 0 0 0 FATHER TOM KNOBLACH DIRECTOR 0.25 1.75 X 0 0 0 JAMES HEBL DIRECTOR 0.25 1.75 X 0 0 0 JEFF GAU DIRECTOR 0.25 1.75 X 0 0 0 JOE UPHUS DIRECTOR 0.25 1.75 X 0 0 0 TERESA BOHNEN DIRECTOR 0.25 1.75 X 0 0 0 TIM WENSMAN DIRECTOR 0.25 1.75 X 0 0 0 CRAIG BROMAN CHIEF OPERATING OFFICER/EVP 6.50 33.50 X 0 1387560 51923 MICHAEL BLAIR CFO/SR VP/TREASURER 1.00 39.00 X 0 544396 73619 SANTO CRUZ CHIEF LEGAL OFFICER/SR VP/SECRETARY 1.00 39.00 X 0 363379 45019 CINDY FIRKINS SMITH MD VICE PRESIDENT 10.00 30.00 X 0 852324 53785 BENEDICT R HAEG DIRECTOR 40.00 0.00 X 0 412898 21616 REBECCA K STEPAN DIRECTOR 40.00 0.00 X 0 387219 28097 DENNIS K HEINEN PHARMACY DIRECTOR 40.00 0.00 X 0 167587 50456 SHANNON R CABRERA PHYSICIAN 40.00 0.00 X 0 521779 64512 MARK A WEISBROD PHYSICIAN 40.00 0.00 X 0 433058 78000 JAMES R SAYOVITZ PHYSICIAN 40.00 0.00 X 0 389614 75678 ULRIKA M WIGERT FAMILY PRACTICE DIRECTOR 20.00 20.00 X 0 406386 46259 ETHAN R GREENBERG PHYSICIAN 40.00 0.00 X 0 391477 44651 0 10154887 888628 0 0 1 0 WEST CENTRAL ANESTHESIA PC 10382 AUGUSTA DRIVE SAUK CENTRE MN 56378 CRNA SERVICES 571071 AYA HEALTHCARE INC DEPT 3519 PO BOX 123519 DALLAS TX 75312 TEMPORARY STAFFING SERVICES 205874 HORIZON VIRTUAL C/O DARIN WILLARDSEN 9886 352ND STR SAINT JOSEPH MN 56374 PHYSICIAN SERVICES 117240 3 X 59216 -227009 -167793 PATIENT & RESIDENT REV 622110 35522389 35522389 SENIOR HOUSING REVENUE 622110 517845 517845 OTHER PROGRAM REVENUE 623311 325473 325473 36365707 2010197 2010197 841521 158752 682769 682769 OTHER REVENUE 623311 5136 5136 5136 38896016 36370843 0 2692966 8335 8335 16010540 11618702 4391838 595761 406109 189652 3636370 2426408 1209962 733568 679116 54452 1556 1556 3379989 2464379 915610 9543 950 8593 118442 56941 61501 1971932 1281756 690176 1846374 1183765 662609 78410 77016 1394 18113 13989 4124 498973 498973 1408191 1349803 58388 161127 60409 100718 DRUGS/MEDICAL SUPPLIES 4613420 4470832 142588 IMPLICIT PRICE CONCESS. 910151 910151 MEDICAID/MN CARE 651233 651233 DUES & AFFILIATIONS 67374 32722 34652 36719402 27540356 9179046 0 12093531 15559692 304915 305372 4723320 4909042 307329 211082 31002 40484 32234411 18937383 13987807 13297028 22925723 29484530 54373627 63807230 5035961 4967621 13407992 13519850 2917952 5539459 21361905 24026930 X 32843886 39612263 167836 168037 33011722 39780300 54373627 63807230 X 2176614 4910224 -318260 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1280 1280 0 PART II-B, LINE 1: CENTRACARE HEALTH - SAUK CENTRE PAID $1,280 TO STATE AND NATIONAL ASSOCIATIONS TO CONDUCT LOBBYING ACTIVITES ON ITS BEHALF, AS A MEMBER OF THE ASSOCIATION. 800000 800000 23859670 13170478 10689192 603464 394969 208495 6966427 5371936 1594491 4850 4850 13297028 OTHER RECEIVABLES 34528 FUNDS DESIGNATED BY BOARD 28513237 OPERATING LEASED ASSETS, NET 165304 INVESTMENTS IN OTHERS 771461 29484530 DUE TO AFFILIATED ORGANIZATIONS 2725687 INTEREST PAYABLE 220866 ST OPERATING LEASE LIABILITY 123651 ACCELERATED ADVANCED PAYMENTS(CMS) 1900000 ASSET RETIREMENT OBLIGATION 339038 LT OPERATING LEASE LIABLITY 41653 FICA PAYROLL TAX DEFERRAL 188564 5539459 X PART X, LINE 2: CENTRACARE, THE CORPORATION, THE CLINIC, CCH - MELROSE, CCH - LONG PRAIRIE, CCH - SAUK CENTRE AND THE FOUNDATION HAVE BEEN DETERMINED TO QUALIFY AS TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CCH - MONTICELLO, CCH - PAYNESVILLE AND CARRIS HEALTH, AS DISREGARDED LIMITED LIABILITY COMPANIES (LLCS) UNDER INTERNAL REVENUE SERVICE REGULATIONS, ACHIEVE TAX-EXEMPT TREATMENT BASED ON THE EXEMPT STATUS OF THEIR PARENT, CENTRACARE HEALTH SYSTEM. AT JUNE 30, 2021 AND 2020, THERE WERE NO UNCERTAIN TAX POSITIONS. 1 1 X 1 X 175.000000000000 1 X 1 1 1 0 1 1 153866 153866 0.00430 8866072 7081344 1784728 0.04980 9019938 7081344 1938594 0.05410 72064 72064 0.00200 27632 27632 0.00080 8145 8145 0.00020 107841 107841 0.00300 9127779 7081344 2046435 0.05710 1 910151 7081631 6817195 264436 X 1 1 1 1 CENTRACARE HEALTH - SAUK CENTRE 425 ELM STREET SAUK CENTRE MN 56378 WWW.CENTRACARE.COM/LOCATIONS/SAUK-CENT 394692 X X X X RURAL HEALTH CLINIC, NURSING HOME CENTRACARE HEALTH - SAUK CENTRE 1 0 0 1 X X X X X X X X X X 18 1 1 1 1 X SEE PART V, PAGE 8 X 1 18 1 SEE PART V, PAGE 8 0 1 X 175.000000000000 250.000000000000 X X 1 1 X X X 1 X CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X CENTRACARE.COM/PRICING-FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X X 1 X 0 0 CENTRACARE HEALTH - SAUK CENTRE PART V, SECTION B, LINE 3J: CENTRACARE UTILIZED THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS) PROCESS TO CONDUCT THE CHNA AND PREPARE THE IMPLEMENTATION STRATEGY WHICH WE CALLED THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE MAPP PROCESS INCLUDES A LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT, STAKEHOLDER INTERVIEWS, COMMUNITY HEALTH SURVEY JOINTLY FUNDED AND MANAGED WITH THREE COUNTY PUBLIC HEALTH DEPARTMENTS, AND SEVERAL COMMUNITY MEETINGS TO GATHER INFORMATION ON FORCES THAT CREATE HEALTH, TRENDS, FACTORS AND EVENTS AFFECTING HEALTH, AND STRATEGIES TO OVERCOME BARRIERS TO HEALTHY LIVING. THE CHNA INCLUDED A HEALTH EQUITY ASSESSMENT AND INFORMATION ON NATIONAL, STATE, AND OTHER LOCAL PLANNING PROCESSES RELATED TO HEALTH.AS A FOLLOW UP TO THE PRIOR CHNA PROCESS WHERE PUBLIC HEALTH DATA WAS A SIGNIFICANT GAP, THIS CHNA AND SUBSEQUENT CHIP WAS A COLLABORATIVE EFFORT EXECUTED WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH, AND STEARNS COUNTY PUBLIC HEALTH. THE RESULT WAS A JOINT CHNA AND CHIP. CENTRACARE HEALTH - SAUK CENTRE PART V, SECTION B, LINE 5: CENTRACARE POPULATION HEALTH CONDUCTED SPECIFIC AND COMPREHENSIVE EVALUATION OF ZIP CODE 56304 THAT HAS THE WORST HEALTH OUTCOMES IN THE THREE COUNTIES INCLUDED IN THE CHNA AND CHIP. THIS EVALUATION INCLUDED DATA EVALUATION, KEY INFORMANT INTERVIEWS, AND HEALTH INDICATORS FOR MINORITY GROUPS. THE CENTRAL MN ALLIANCE ALSO COMPLETED SEVERAL SURVEYS AND ASSESSMENTS TO GET INPUT FROM MULTIPLE SECTORS OF EACH COMMUNITY REPRESENTING DIFFERENT POPULATIONS IN ORDER TO COMPILE A LIST OF TOP PRIORITIES IN THE REGION:THE COMMUNITY HEALTH STATUS ASSESSMENT (CHSA) WAS DATA COLLECTED FROM THE COMMUNITY HEALTH ASSESSMENT COMPLETED IN 2016, CENTRACARE PATIENT DATA, MINNESOTA STUDENT SURVEY DATA, AND MINNESOTA PUBLIC HEALTH VITAL STATISTICS. THIS DATA WAS COMPARED TO DOCUMENTS AND DATASETS FROM THE MN STATEWIDE HEALTH ASSESSMENT (SHA), CENTRAL MN COMMUNITY HEALTH SURVEY DATA, PREVIOUS PLANNING PROCESS PRIORITY LISTS, HEALTH EQUITY DATA ANALYSES (HEDA) FROM EACH COUNTY, TYPES OF DATA REQUESTS OUR AGENCIES WERE GETTING FROM THE PUBLIC, AND THE MN DEPARTMENT OF HEALTH DATA INDICATOR LIST. A "COMMUNITY PIRORITY CATEGORY" WAS ASSIGNED TO EACH DATA POINT TO IDENTIFY A LIST OF COMMUNITY PRIORITIES.THE COMMUNITY THEMES AND STRENGTHS ASSESSMENT (CTSA) WAS CONDUCTED IN THE FORM OF KEY STAKEHOLDER INTERVIEWS VIA PHONE WITH A WIDE VARIETY OF COMMUNITY PARTNERS THROUGHOUT THE THREE COUNTIES. A TOTAL OF 50 STAKEHOLDERS WERE INTERVIEWED FROM 20 DIFFERENT SECTORS INCLUDING YOUTH, PARENT, SMALL BUSINESS OWNER, CORPORATE BUSINESS OWNER, MEDIA, SCHOOL/EDUCATION, YOUTH-SERVING ORGANIZATION, LAW ENFORCEMENT, RELIGIOUS OR FAITH-BASED ORGANIZATION, PRIMARY HEALTHCARE, BEHAVIORAL HEALTH, HOSPITAL-BASED HEALTHCARE, STATE/LOCAL GOVERNMENT- ELECTED, STATE/LOCAL GOVERNMENT- NON-ELECTED, NON-PROFIT, CIVIC/VOLUNTEER GROUP, VETERANS INTEREST GROUP, AGING POPULATION INTEREST GROUP, ENVIRONMENTAL INTEREST GROUP, AND MINORITY INTEREST GROUP.FOR THE LOCAL PUBLIC HEALTH SYSTEM ASSESSMENT (LPHSA) BENTON, SHERBURNE, AND STEARNS COUNTY LPH AGENCIES PARTICIPATED IN A CAPACITY ASSESSMENT TO HELP DETERMINE THE EXTENT TO WHICH REQUIRED LOCAL PUBLIC HEALTH ACTIVITIES ARE IN PLACE STATEWIDE. THE ASSESSMENT QUESTIONS WERE THEN UTILIZED TO FORMULATE A SURVEY FOR THREE SECTORS OF THE LOCAL PUBLIC HEALTH SYSTEM: EMERGENCY PREPAREDNESS, ENVIRONMENTAL HEALTH, AND HEALTHCARE ACCESS/INFECTIOUS DISEASE. COMMUNITY PARTNERS WERE INVITED TO PARTICIPATE IN THE SURVEY VIA EMAIL. AFTER ANALYZING THE RESULTS, THE LPHSA SUBGROUP DEVELOPED A LIST OF THEIR TOP 10 RECOMMENDATIONS FROM ALL 3 SECTORS TO SUPPORT THE DEVELOPMENT OF THE COMMUNITY COMMUNITY HEALTH IMPROVEMENT PLAN.THE FORCES OF CHANGE (FOC) ASSESSMENT WAS COMPLETED IN THE FORM OF A COMUNITY MEETING IN AUGUST OF 2018 TO IDENTIFY FORCES THAT MAY AFFECT A COMMUNITY AND OPPORTUNITIES AND THREATS ASSOCIATED WITH THOSE FORCES. THE AGENDA INCLUDED A BRAINSTORMING ACTIVITY AND TIME IN SMALL GROUP AND LARGE GROUP DISCUSSION. A FLIER ADVERTISING THE MEETING WAS DISTRIBUTED TO COMMUNITY MEMBERS VIA EMAIL. THERE WERE 68 PEOPLE THAT ATTENDED REPRESENTING 27 ORGANIZATIONS AND TWO THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. AS A FOLLOW UP TO THE FORCES OF CHANGE COMMUNITY MEETING, A WORLD CAFE WAS HELD IN JANUARY 2019 FOR MEMBERS OF THE COMMUNITY TO COME AND TALK ABOUT THEIR PERCEPTION OF NEEDS IN THE SURROUNDING COMMUNITIES. THERE WERE 94 PEOPLE THAT ATTENDED THE MEETING REPRESENTING 32 ORGANIZATIONS AND THREE THAT IDENTIFIED THEIR AFFILIATION AS 'COMMUNITY MEMBER'. ORGANIZATIONS THAT WERE REPRESENTED AT BOTH COMMUNITY MEETINGS INCLUDED LOCAL GOVERNMENT, HEALTHCARE, LOCAL NONPROFITS, EDUCATION, UNDERREPRESENTED COMMUNITIES, FAITH COMMUNITY, AND OTHERS.IN ORDER TO BETTER ENGAGE INDIVIDUALS OR ORGANIZATIONS WITH A PERSPECTIVE OF AT-RISK POPULATIONS, A HEALTH EQUITY ASSESSMENT WAS ALSO COMPLETED. FOCUS-GROUP MEETINGS WERE HELD ON THREE SEPARATE OCCASIONS AT THE GREAT RIVER REGIONAL LIBRARY IN ST. CLOUD, AND COMMUNITY INPUT WAS GATHERED AT THE BENTON, SHERBURNE, AND STEARNS COUNTY FAIRS TO REACH OUT TO A VARIETY OF COMMUNITIES. IN TOTAL, THERE WERE 30 SOMALI ADULTS WHO DISCUSSED POSITIVES, NEGATIVES, AND AREAS-TO-IMPROVE-ON WITHIN THE COMMUNITY. AT THE COUNTY FAIRS, INFORMATION WAS GATHERED FROM RESPONDENTS FROM THE 56304-ZIP CODE. CENTRACARE HEALTH - SAUK CENTRE PART V, SECTION B, LINE 6A: CENTRACARE HEALTH SYSTEM - SAUK CENTRE CONDUCTED THE CHNA WITH CENTRACARE PAYNESVILLE, CENTRACARE MELROSE, AND ST. CLOUD HOSPITAL. CENTRACARE HEALTH - SAUK CENTRE PART V, SECTION B, LINE 6B: CENTRACARE HEALTH SYSTEM - SAUK CENTRE CONDUCTED THE CHNA WITH BENTON COUNTY PUBLIC HEALTH, SHERBURNE COUNTY PUBLIC HEALTH AND STEARNS COUNTY PUBLIC HEALTH. CENTRACARE HEALTH - SAUK CENTRE PART V, SECTION B, LINE 11: THE PRIORITIZATION PROCESS TOOK PLACE WHILE UTILIZING THE MAPP PROCESS. THE WORK OF EACH OF THE FOUR MAPP ASSESSMENT SUB-GROUPS RESULTED IN FOUR LISTS OF 10 COMMUNITY PRIORITIES. AS A REMINDER, THE FOUR ASSESSMENTS INCLUDE: COMMUNITY HEALTH STATUS ASSESSMENT, COMMUNITY THEMES AND STRENGTHS ASSESSMENT, LOCAL PUBLIC HEALTH STATUS ASSESSMENT, AND FORCES OF CHANGE ASSESSMENT. THOSE FOUR LISTS OF 10 ARE INCLUDED IN THE NARRATIVE EARLIER IN THIS DOCUMENT.THE CORE SUPPORT TEAM WAS PROVIDED THOSE FOUR LISTS OF TEN PRIORITIES. THEY TOOK THOSE LISTS AND TALKED WITH THEIR AGENCY STAFF TO IDENTIFY ANY THEMES OR COMMONALITIES AMONGST THE FOUR LISTS. THE CORE SUPPORT TEAM THEN CAME TOGETHER IN A MEETING AND WENT THROUGH A FACILITATED PROCESS USING THE CENTRAL MN ALLIANCE VISION AS A GUIDE TO COME UP WITH A TOP 10 LIST TO SEND ON TO THE DELEGATED AUTHORITIES.THE DELEGATED AUTHORITIES MET AND CONTINUED THE DISCUSSION ABOUT THE PRIORITY LIST. THE PRIORITIES PASSED ON BY THE CORE SUPPORT TEAM WERE RUN THROUGH TWO PRIORITIZATION EXERCISES. THE FIRST WAS A RANKING DISCUSSION WITH POINTS ASSIGNED FOR CERTAIN CRITERIA. RANKS INCLUDED 3 FOR HIGH, 2 FOR MEDIUM, AND 1 FOR LOW. THE CRITERIA INCLUDED: URGENCY: IS THIS A PRIORITY ISSUE THAT NEEDS TO BE ADDRESSED IN THE NEXT 1-3 YEARS? POTENTIAL IMPACT: IS IT LIKELY THAT ADDRESSING THIS CRITICAL ISSUE WILL HAVE A SIGNIFICANT IMPACT ON ONE OR MORE SPECIFIC POPULATIONS? DO YOU HAVE REASON TO BELIEVE YOU CAN BE SUCCESSFUL ON THIS ISSUE? ACTIONABLE/FEASIBLE: ARE THERE OPPORTUNITIES FOR ACTION TO ADDRESS THE CRITICAL ISSUE? IS THERE ROOM TO MAKE MEANINGFUL IMPROVEMENT ON THE ISSUE? RESOURCES: ARE RESOURCES (FUNDS, STAFF, & EXPERTISE) EITHER READILY AVAILABLE OR LIKELY RESOURCES CAN BE OBTAINED TO ADDRESS THE CRITICAL ISSUE? ARE THERE RESOURCES THROUGH THE STATE AND COMMUNITY MEMBERS TO WORK ON THE ISSUE? IF NOT, CAN RESOURCES BE ACQUIRED? COMMUNITY READINESS: IS THIS A CRITICAL ISSUE IDENTIFIED AS IMPORTANT BY THE COMMUNITY? ARE PEOPLE IN THE COMMUNITY INTERESTED IN THE ISSUE? IS THERE COMMUNITY MOMENTUM TO MOVE THIS INITIATIVE FORWARD? INTEGRATION: IS THERE OPPORTUNITY FOR COLLABORATION? IS THERE OPPORTUNITY TO BUILD ON EXISTING INITIATIVES? WILL THIS DUPLICATE EFFORTS? FINALLY, THE PRIORITIES WERE PLACED ON A CONTROL/INFLUENCE GRID.THE PRIORITIES IDENTIFIED WERE AS FOLLOWS IN COMMUNITY INFORMED RANKING: 1) BUILDING FAMILIES, 2) MENTAL HEALTH, 3) ENCOURAGING SOCIAL CONNECTION, 4) ADVERSE CHILDHOOD EXPERIENCES (ACES), 5) TOBACCO/NICOTINE USE, 6) HEALTH CARE, 7) RISKY YOUTH BEHAVIOR, 8) FINANCIAL STRESS, 9) TRAUMA, AND 10) EDUCATING POLICY MAKERS AND KEY COMMUNITY STAKEHOLDERS. DUE TO THE NEWNESS OF THE COLLABORATION ON THIS WORK, A DECISION WAS MADE TO FOCUS ON THE TOP TWO PRIORITIES FOR THE COMMUNITY HEALTH IMPROVEMENT PLAN. THE PRIORITIES THREE THROUGH TEN WILL NOT SPECIFICALLY BE ADDRESSED THROUGH ACTION PLANNING OR MEASUREMENT, HOWEVER, THERE ARE WAYS MANY OF THESE PRIORITIES ARE BEING ADDRESSED EITHER WITHIN THE TOP TWO PRIORITIES OR THE COMMUNITY. IN THE FUTURE, THE GROUP WILL ASSESS THE CAPACITY TO EXPAND THE NUMBER OF PRIORITIES BEING ADDRESSED AND MEASURED. ALTHOUGH NOT DIRECTLY ADDRESSED IN THE PLAN, CENTRACARE DOES ACTIVELY SUPPORT OTHER ORGANIZATIONS WITHIN THE COMMUNITY WHO ARE WORKING ON DETERMINANTS OF HEALTH IDENTIFIED DURING THE CHNA PROCESS LIKE ACES, TOBACCO, TRAUMA, EDUCATING POLICYMAKERS, ETC.THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IS THE ACTION PLAN THAT USES GUIDING PRINCIPLES AND STRATEGIES TO ADDRESS THE COMMUNITY PRIORITIES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THE TOP PRIORITIES ARE BUILDING FAMILIES AND MENTAL HEALTH. WE WILL USE THE GUIDING PRINCIPLES OF COMMUNITY COLLABORATION, AWARENESS, RESILIENCE, EQUITY, EDUCATION, AND HEALTH ORGANIZATIONS TO DRIVE OUR STRATEGIES. IN THE CURRENT FISCAL YEAR THE ORGANIZATION LOOKED AT GRANTS FOR SCHOOLS TO TEACH IN THEIR CURRICULUM AND LOOKED AT PARTNERING WITH OTHER ORGANIZATIONS TO OFFER CLASSES/RESOURCES FOR THOSE IN NEED OF PARENTING SKILLS AND CAREGIVER RESOURCES. THEY ALSO LOOKED INTO CREATING SUPPORT GROUPS, MEDICATION ASSISTED TREATMENT AND ADDITIONAL AWARENESS WITHIN THE COMMUNITY REGARDING MENTAL HEALTH NEEDS.THE ST. CLOUD HOSPITAL, CENTRACARE- MELROSE HOSPITAL, CENTRACARE- SAUK CENTRE, AND CENTRACARE- PAYNESVILLE WILL MAINTAIN THEIR ENGAGEMENTS WITH THE CENTRAL MN ALLIANCE AND FOLLOW THE MAPP LEADERSHIP STRUCTURE TO CARRY OUT THE STRATEGIES OUTLINED IN THE CHIP. THERE WILL BE MEETINGS AS OUTLINED IN THE CHIP UNDER LEADERSHIP SYSTEM & PROCESS FOR MONITORING AND REVISION. TO SEE THE FULL CHIP GO TO THE CENTRACARE WEBSITE AT HTTPS://WWW.CENTRACARE.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/. CENTRACARE HEALTH - SAUK CENTRE PART V, SECTION B, LINE 13H: A NON-CITIZEN CAN BE DENIED CARE IF THEY CAME TO THE US SPECIFICALLY TO RECEIVE FREE CARE.PRESUMPTIVE ELIGIBILITY - IF PATIENTS FAIL TO SUPPLY SUFFICIENT INFORMATION TO SUPPORT FINANCIAL ASSISTANCE ELIGIBILITY, CENTRACARE HEALTH MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES TO DETERMINE ELIGIBILITY WHEN:(A) PATIENT IS HOMELESS(B) PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS(C) PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM(D) PATIENT IS ELIGIBLE FOR A STATE-FUNDED PRESCRIPTION MEDICATION PROGRAM(E) PATIENT'S VALID ADDRESS IS CONSIDERED LOW-INCOME OR SUBSIDIZED HOUSING(F) PATIENT RECEIVES FREE CARE FROM A COMMUNITY CLINIC AND IS REFERRED TO HOSPITAL FOR FURTHER TREATMENT CENTRACARE HEALTH - SAUK CENTRE PART V, SECTION B, LINE 16J: PATIENTS WHO ARE AT A SELF PAY STATUS RECEIVE FINANCIAL ASSISTANCE INFORMATION EITHER VIA A TELEPHONE CALL OR ON BILLING STATEMENTS. CENTRACARE HEALTH - SAUK CENTRE PART V, SECTION B, LINE 20E: OUR CREDIT COLLECTION AGENCIES ARE REQUIRED TO PROVIDE CHARITY INFORMATION AS PART OF THEIR COLLECTION PROCESS PRIOR TO ANY CONSIDERATION OF LEGAL ACTION AGAINST THE PATIENT. CENTRACARE HEALTH - SAUK CENTRE: PART V, SECTION B, LINE 7A: THE HOSPITAL'S CHNA CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP_CHNA-2019-2022-VERSION-2-UPDATED-02.20.PDF.PART V, SECTION B, LINE 10A: THE HOSPITAL'S IMPLEMENTATION PLAN CAN BE FOUND ON ITS WEBSITE AT WWW.CENTRACARE.COM/DOCUMENTS/ABOUT/CENTRAL-MN-ALLIANCE-CHIP_CHNA-2019-2022-VERSION-2-UPDATED-02.20.PDF. SCHEDULE H, PART V, SECTION B, LINE 22B THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH REV. PROC. 2015-21 SECTION 7 IN REGARDS TO SCHEDULE H, PART V, SECTION B, LINE 22B. DURING THE TAX PERIOD ENDED JUNE 30, 2021, THE FINANCIAL ASSISTANCE POLICY DID NOT INCLUDE THE PERCENTAGE CALCULATED FOR THE "AMOUNTS GENERALLY BILLED" USING THE LOOK BACK METHOD. CENTRACARE IDENTIFIED THIS ERROR IN MARCH 2022 DURING THE PREPARATION OF THE FORM 990 FOR THE TAX PERIOD ENDED JUNE 30, 2021 AND CORRECTED THIS ERROR IN APRIL 2022. THIS ERROR WAS MINOR AND INADVERTENT AND CORRECTIVE ACTIONS WERE TAKEN AFTER THE DISCOVERY OF THE ERROR. 3 1 - SAUK CENTRE LAKESHORE ESTATES 501 LAKESHORE DRIVE SAUK CENTRE MN 56378 SENIOR HOUSING APARTMENT BUILDING 2 - SAUK CENTRE CLINIC 425 ELM STREET NORTH SAUK CENTRE MN 56378 RURAL HEALTH CLINIC 3 - SAUK CENTRE CARE CENTER 425 ELM STREET NORTH SAUK CENTRE MN 56378 NURSING HOME PART I, LINE 6A: CENTRACARE HEALTH SYSTEM PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT THAT INCLUDES ALL RELATED ORGANIZATIONS. PART I, LINE 7: THE ORGANIZATION'S TOTAL EXPENSES WERE REDUCED BY THEIR NON-OPERATING REVENUE, MEDICAID SURCHARGE AND MN CARE TAX. THE NET TOTAL EXPENSES WERE THEN DIVIDED BY GROSS CHARGES TO DETERMINE THE COST TO CHARGE RATIO. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $910,151 PART II, COMMUNITY BUILDING ACTIVITIES: THE HEALTH SYSTEM PROVIDED DRIVE THROUGH TEST SITES, FREE VACCINATION CLINICS, MANDATED EMPLOYEE VACCINATION, TRAINING, SCREENING, PRODUCTS TO ENSURE SAFE ENVIRONMENTS, AND OTHER VARIOUS SERVICES/PRODUCTS. PART III, LINE 2: THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PART III, LINE 4: THE FOLLOWING IS FROM THE "ACCOUNTS RECEIVABLE" PARAGRAPH INCLUDED IN NOTE 2 ON PAGE 11 OF THE ORGANIZATION'S AUDITED FINANCIALS."CENTRACARE REPORTS PATIENT AND RESIDENT SERVICE REVENUE AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH CENTRACARE EXPECTS TO BE ENTITLED TO IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS AND THIRD-PARTY PAYORS (INCLUDING MEDICARE, MEDICAID, BLUE CROSS AND OTHER THIRD-PARTY PAYORS). CERTAIN REIMBURSEMENT ARRANGEMENTS INCLUDE VARIABLE CONSIDERATION FOR AMOUNTS SUBJECT TO RETROACTIVE AUDIT AND ADJUSTMENT. DIFFERENCES BETWEEN AMOUNTS ORIGINALLY RECORDED AND FINALLY SETTLED ARE INCLUDED IN OPERATIONS IN THE YEAR IN WHICH THE DIFFERENCES ARE KNOWN. REVENUE IS RECOGNIZED AS PERFORMANCE OBLIGATIONS ARE SATISFIED." PART III, LINE 8: THE AMOUNT ON LINE 7 OF PART III WAS DETERMINED UTILIZING THE MEDICARE COST REPORT UTILIZING KEY SECTION OF THAT REPORT - WORKSHEETS D, E, K AND H. PART III, LINE 9B: THE COLLECTION POLICIES AT THE ORGANIZATION REQUIRE COLLECTION STAFF TO OFFER CHARITY TO PATIENTS WHO INDICATE THAT PAYMENT MAY BE AN ISSUE. IF A PATIENT DOES QUALIFY FOR FULL CHARITY, ALL OTHER COLLECTION EFFORTS MUST CEASE. IF A PATIENT QUALIFIES FOR PARTIAL CHARITY, COLLECTION EFFORTS WILL CONTINUE ON THE BALANCE OF THE ACCOUNT. THESE PROVISIONS APPLY TO BOTH HOSPITAL EMPLOYED COLLECTION STAFF AND COLLECTION AGENCY STAFF. NO PATIENTS, WHETHER THEY QUALIFY FOR CHARITY OR NOT, ARE REPORTED TO CREDIT REPORTING AGENCIES. PART VI, LINE 2: THE ORGANIZATIONS' STRATEGIC PLANNING ASSESSES THE NEEDS OF THE COMMUNITY AND PATIENTS THROUGH PATIENT SATISFACTION SURVEYS, COMMENT CARDS, COMMUNITY ASSESSMENTS AND A DIVERSE OPERATING COMMITTEE THAT REPRESENTS THE COMMUNITY AND BRINGS TO THE TABLE ISSUES, CONCERNS AND RECOMMENDATIONS FOR HEALTH CARE SERVICES. PART VI, LINE 3: INPATIENTS WHO ARE SELF PAY ARE IDENTIFIED, AND A REPRESENTATIVE OF THE ORGANIZATION'S BILLING DEPARTMENT EXPLAINS THE CHARITY CARE POLICY TO PATIENTS. THEY ALSO EXPLAIN THE SELF PAY DISCOUNT AND SCREENS THE PATIENT FOR ELIGIBILITY FOR ANY STATE OR FEDERAL PROGRAMS. THEY ALSO ASSIST THE PATIENT WITH ANY PAPERWORK REQUIRED TO APPLY FOR SUCH PROGRAMS. OUTPATIENTS WHO ARE SELF PAY RECEIVE AN AUTOMATIC SELF PAY DISCOUNT. IF THE PATIENT DOES NOT REMIT PAYMENT, COLLECTION STAFF ATTEMPT TO REACH THE PATIENT BY PHONE. PATIENTS ARE TOLD ABOUT THE CHARITY PROGRAM. FOR BOTH INPATIENTS AND OUTPATIENTS, ALL STATEMENTS CONTAIN A LETTER REGARDING THE AVAILABILITY OF CHARITY CARE. ALSO ALL PRECOLLECTION LETTERS HAVE THIS SAME LANGUAGE INDICATING THE AVAILABILITY AND PROCESS OF OBTAINING CHARITY CARE. PART VI, LINE 4: SAUK CENTRE IS LOCATED IN STEARNS COUNTY, AND IS PRIMARILY AN AGRICULTURAL COMMUNITY. THE ESTIMATED 2021 CENSUS SHOWS THE POPULATION IS 8,180 AND IS EXPECTED TO GROW SLIGHTLY TO 8,393 BY 2026 FOR AN INCREASE OF 2.60%. THE PROJECTED GROWTH BY AGE BRACKET FROM 2021 TO 2026 IS AS FOLLOWS: 0-17: 6.06%, 18-44: 4.89%, 45-64: -7.94%, 65+: 6.75%. THE ESTIMATED 2021 ETHNIC MIX IS AS FOLLOWS: CAUCASIAN: 90.57%, AFRICAN AMERICAN: 1.54%, ASIAN: 0.31%, HISPANIC: 6.41%, OTHER: 1.17%. PART VI, LINE 5: THE ORGANIZATION HAS A COMMUNITY BASED OPERATING COMMITTEE THAT MEETS ON A MONTHLY BASIS TO REVIEW VARIOUS ASPECTS OF THE FACILITY AND PROVIDE INPUT ON THOSE ASPECTS FROM A COMMUNITY PERSPECTIVE. THE ORGANIZATION PARTICIPATES IN THE COMMUNITY BLOOD DRIVES BY PROVIDING FOOD AND SUPPLIES FOR BOTH THE WORKERS AND BLOOD DONORS. THE FACILITY ALSO SPONSORS A HEALTH FAIR ON AN ANNUAL BASIS FOR THE LOCAL AND SURROUNDING COMMUNITIES. PART VI, LINE 6: THE ORGANIZATION IS PART OF CENTRACARE HEALTH SYSTEM (CCHS) WHICH PROVIDES A BROAD RANGE OF HEALTH CARE SERVICES TO THE PATIENTS OF CENTRAL MINNESOTA. CCHS IS DEDICATED TO IMPROVING THE HEALTH OF PEOPLE LIVING AND WORKING IN THE COMMUNITIES IT SERVES. TO ACCOMPLISH ITS GOALS IT WORKS ACTIVELY WITH ITS AFFILIATE HEALTH CARE ORGANIZATIONS. CCHS CONTINUES TO FOCUS ON PROVIDING THE BEST CARE POSSIBLE AND IN REINVESTING INTO THE COMMUNITY. CCHS ALSO PROMOTES WELLNESS BY SPONSORING PROGRAMS AND EVENTS IN LOCAL COMMUNITIES THAT FOCUS ON HEALTHY EATING AND EXERCISE, AND BY CONDUCTING SCREENINGS FOR CONDITIONS SUCH AS HIGH BLOOD PRESSURE. PART VI, LINE 7, REPORTS FILED WITH STATES MN 1 0 0 SCHOLARSHIPS FOR ADVANCING EDUCATION 13 8335 PART I, LINE 2: "THE CLASSES ARE POSTED AS "POSITIONS" ON THE WEBSITE THAT PEOPLE CAN APPLY TO. THE APPLICATIONS ARE SCREENED BY RECRUITMENT AND IF SELECTED, SET UP FOR AN INTERVIEW WITH THE HIRING MANGER AT THE SITE. IF THE HIRING MANAGER WISHES TO PROCEED, THEY ARE OFFERED A POSITION BY THE RECRUITER TO TAKE THE CNA CLASS BUT THEN ALSO TO TAKE A PART TIME OR FULL TIMES POSITION AS A CNA IN ONE OF OUR ENTITIES ONCE THEY COMPLETE THE CLASS, SKILLS, AND TEST. ANYONE THAT APPLIES AND IS NOT SELECTED, THE RECRUITMENT TEAM WOULD HAVE NOTES AND TRACKING ITEMS FOR THIS IN ORACLE. " 0 1 0 0 0 0 0 1 0 KENNETH D HOLMEN MD PRESIDENT/CEO 0 1025380 0 0 0 397740 0 14981 0 27578 0 1465679 0 0 CRAIG BROMAN CHIEF OPERATING OFFICER/EVP 0 956517 0 250000 0 181043 0 27625 0 24298 0 1439483 0 199215 CINDY FIRKINS SMITH MD VICE PRESIDENT 0 618886 0 105282 0 128156 0 26000 0 27785 0 906109 0 0 DONALD JURGENS MD DIRECTOR 0 853816 0 4650 0 4702 0 5688 0 15042 0 883898 0 0 MICHAEL BLAIR CFO/SR VP/TREASURER 0 524778 0 0 0 19618 0 45500 0 28119 0 618015 0 0 CHRISTIAN P SCHMIDT MD DIRECTOR 0 500526 0 8549 0 5153 0 45500 0 27874 0 587602 0 0 SHANNON R CABRERA PHYSICIAN 0 513734 0 4650 0 3395 0 39000 0 25512 0 586291 0 0 MARK A WEISBROD PHYSICIAN 0 423332 0 0 0 9726 0 39000 0 39000 0 511058 0 0 JAMES R SAYOVITZ PHYSICIAN 0 375110 0 6577 0 7927 0 45500 0 30178 0 465292 0 0 RICHARD A WEHSELER MD DIRECTOR 0 319512 0 79432 0 4810 0 26000 0 32681 0 462435 0 0 ULRIKA M WIGERT FAMILY PRACTICE DIRECTOR 0 387098 0 12175 0 7113 0 19500 0 26759 0 452645 0 0 ETHAN R GREENBERG PHYSICIAN 0 391160 0 0 0 317 0 19500 0 25151 0 436128 0 0 BENEDICT R HAEG DIRECTOR 0 399462 0 6577 0 6859 0 0 0 21616 0 434514 0 0 BRYAN ROLPH MD DIRECTOR 0 414480 0 11503 0 5966 0 0 0 1783 0 433732 0 0 REBECCA K STEPAN DIRECTOR 0 364526 0 15400 0 7293 0 0 0 28097 0 415316 0 0 SANTO CRUZ CHIEF LEGAL OFFICER/SR VP/SECRETARY 0 336391 0 0 0 26988 0 19500 0 25519 0 408398 0 0 SHARON J RUGGIERO MD DIRECTOR 0 242774 0 9089 0 9128 0 45500 0 12386 0 318877 0 0 DENNIS K HEINEN PHARMACY DIRECTOR 0 160733 0 0 0 6854 0 26000 0 24456 0 218043 0 0 PART I, LINE 3 THE COMPENSATION PAID TO THE PRESIDENT AND VICE PRESIDENTS (NON-MEDICAL PROVIDERS) IS DETERMINED BY CENTRACARE HEALTH SYSTEM, A RELATED ORGANIZATION. CENTRACARE HEALTH SYSTEM USES THE FOLLOWING METHODS TO DETERMINE COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PART I, LINE 4B THE CORPORATIONS' EXECUTIVES ARE ELIGIBLE TO PARTICIPATE IN BENEFIT PLANS WHICH INCLUDE TAX DEFERRED NON-QUALIFIED INVESTMENT ACCOUNTS. THESE PLANS MAY PROVIDE, BUT ARE NOT CERTAIN TO PROVIDE, FOR PAYMENT OF TAX DEFERRED COMPENSATION TO THESE EXECUTIVES AT SOME TIME IN THE FUTURE. THE EXECUTIVE HAS NO LEGAL RIGHT TO THESE DOLLARS UNTIL, AND UNLESS, CERTAIN FUTURE EVENTS OCCUR. IN ACCORDANCE WITH THE INSTRUCTIONS TO FORM 990, THE AMOUNTS LISTED IN PART VII AND SCHEDULE J, PART II, COLUMN C, REFLECT TAX DEFERRED COMPENSATION. THIS COMPENSATION IS POTENTIALLY REPORTED TWICE ON FORM 990 - ONCE WHEN THE COMPENSATION IS DEFERRED OR ACCRUED AND AGAIN IF AND WHEN IT IS PAID TO THE EXECUTIVE. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE NON-QUALIFIED PLAN: CRAIG BROMAN - PAID $199,215 PART I, LINE 7 THE ORGANIZATION PROVIDES INCENTIVE COMPENSATION TO DESIGNATED INDIVIDUALS BASED ON FOUR DISCRETE AREAS: STEWARDSHIP, THROUGH A COMPARISON BETWEEN BUDGETED AND ACTUAL NET OPERATING INCOME FOR SAINT CLOUD HOSPITAL AND/OR CENTRACARE HEALTH SYSTEM AS WELL THROUGH ACHIEVING METRICS FOR AN IDENTIFIED COST REDUCTION PROGRAM; QUALITY, THROUGH ACHIEVING SAINT CLOUD HOSPITAL AND SYSTEM QUALITY METRICS; PATIENT EXPERIENCE, THROUGH ACHIEVEMENT OF PATIENT SATISFACTION GOALS AS COMPARED TO NATIONAL AND BASELINE RANKINGS; AND PEOPLE/EMPLOYEES, THROUGH ACHIEVEMENT OF SPECIFIED EMPLOYMENT SATISFACTION GOALS AND HIRING AND/OR RETENTION GOALS. THE INCENTIVE COMPENSATION PAID OUT IS NOT A PORTION OR PERCENTAGE OF ACTUAL NET EARNINGS OF ANY CENTRACARE HEALTH SYSTEM AFFILIATE, HOWEVER NET EARNINGS GOALS ARE REQUIRED TO BE MET BEFORE THE INCENTIVE COMPENSATION IS PAID. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF CENTRACARE HEALTH SYSTEM - SAUK CENTRE IS CENTRACARE HEALTH SYSTEM, A MINNESOTA NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A CENTRACARE HEALTH SYSTEM, AS THE SOLE CORPORATE MEMBER HAS THE AUTHORITY TO APPOINT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING MATTERS ARE RESERVED FOR ACTION BY CENTRACARE HEALTH SYSTEM, THE SOLE MEMBER: 1. ADOPTION OF AMENDMENTS TO THE ARTICLES OF INCORPORATION OR BYLAWS. 2. APPOINTMENT OF DIRECTORS AND OFFICERS. 3. APPROVAL OF THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS AND ANY DEBTS TO BE INCURRED. 4. APPROVAL OF ALL STRATEGIC PLANS. 5. DETERMINATION OF THE DISSOLUTION OF OR THE DISCONTINUATION OF THE BUSINESS OF THE CORPORATION. 6. APPROVAL OF ANY TRANSACTION WHICH MAY AFFECT THE CORPORATION'S STATUS AS AN ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXATION. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS HAS DELEGATED THE APPROVAL AUTHORITY OF THE FORM 990 TO THE AUDIT COMMITTEE. ANNUALLY, AT THE AUDIT COMMITTEE MEETING, PRIOR TO FILING WITH THE IRS, THE AUDIT COMMITTEE REVIEWS AND APPROVES FORM 990. A COPY OF FORM 990 IS THEN PROVIDED FOR THE FULL BOARD TO REVIEW PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN A CONFLICT OF INTEREST QUESTIONNAIRE TWICE A YEAR. ALL STAFF SIGN CONFLICTS OF INTEREST FORMS ON AN ANNUAL BASIS. THE QUESTIONNAIRES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AS WELL AS THE CORPORATE COMPLIANCE GROUP (A COMPLIANCE COMMITTEE WHICH INCLUDES INTERNAL MEMBERS AND OUTSIDE COUNSEL). THE RESPONSES TO THE QUESTIONNAIRES ARE THEN REVIEWED WITH THE EXECUTIVE COMMITTEE OF THE BOARD. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING CONFLICTS OF INTERESTS RELATED TO BOARD AND STAFF AND TO ALERT AFFECTED PARTIES WHEN A CONFLICT ARISES. WHEN AN ACTUAL CONFLICT ARISES, THE AFFECTED PARTY IS ASKED TO RECUSE HIM/HER SELF FROM THE DECISION MAKING PROCESS. THE CORPORATE COMPLIANCE OFFICER ATTENDS BOARD MEETINGS AND SPECIFIED BOARD COMMITTEE MEETINGS WHERE CONFLICT ISSUES MAY ARISE. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION AND BENEFITS OF THE PRESIDENT ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS DONE JUNE 2021. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. COULD HOSPITAL TO PERFORM SERVICES. THE COMPENSATION AND BENEFITS OF THE VICE PRESIDENTS (NON-MEDICAL PROVIDERS) ARE SUBJECT TO FULL COMPENSATION AND BENEFITS COMPARABILITY STUDIES CONDUCTED BIENNIALLY BY A THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT. HOWEVER, THE COMPENSATION PORTION OF THE STUDY IS REVIEWED ANNUALLY BY THE CONSULTANT AND UPDATED FOR COMPENSATION COMMITTEE AND BOARD OF DIRECTORS REVIEW AND APPROVAL. THE MOST RECENT FULL REVIEW WAS COMPLETED IN JUNE 2021. THE THIRD PARTY INDEPENDENT COMPENSATION CONSULTANT IS RETAINED BY ST. CLOUD HOSPITAL TO PERFORM THESE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES NOT GENERALLY MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE HOSPITAL/CENTRACARE HEALTH SYSTEM DOES DO AN ANNUAL REPORT TO THE COMMUNITY IN WHICH FINANCIAL RESULTS ARE REPORTED TO AND DISCUSSED WITH THE PUBLIC. THIS REPORT IS AVAILABLE TO THE PUBLIC ON THE ORGANIZATION'S WEBSITE. PART VIII, LINE 1E NEGATIVE REVENUE IS ATTRIBUTABLE TO HHS REGULATION CHANGES RELATED TO POOLED FUNDING AND TARGETED FUNDING FOR COVID RELIEF. FORM 990, PART XI, LINE 9: TRANSFER TO POOLED INVESTMENT ACCT TO CCHS -318,260. FORM 990, PART XII, LINE 3B: DUE TO COVID-19 THE OFFICE OF MANAGEMENT AND BUDGET EXTENDED THE SINGLE AUDIT DUE DATE. DUE TO THIS THE SINGLE AUDIT REQUIRED TO BE COMPLETED IS IN PROCESS, HOWEVER THE JUNE 30, 2020 SINGLE AUDIT HAS BEEN COMPLETED. CENTRACARE HEALTH SYSTEM 1406 6TH AVENUE NORTH SAINT CLOUD MN 56303 411813221 INTEGRATED HEALTH SYSTEM MN 501(C)(3) 3 N/A 0 ST CLOUD HOSPITAL 1406 6TH AVENUE NORTH SAINT CLOUD MN 56303 410695596 ACUTE/LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 0 CENTRACARE HEALTH - MELROSE 11 NORTH 5TH AVENUE WEST MELROSE MN 56352 411865315 ACUTE/LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 1 CENTRACARE HEALTH - LONG PRAIRIE 50 CENTRACARE DRIVE LONG PRAIRIE MN 56347 411924645 ACUTE/LT CARE MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 1 CENTRACARE CLINIC 1200 6TH AVENUE NORTH SAINT CLOUD MN 56303 411806657 MULTI-SPECIALTY MN 501(C)(3) 3 CENTRACARE HEALTH SYSTEM 1 CENTRACARE HEALTH FOUNDATION 1406 6TH AVENUE NORTH SAINT CLOUD MN 56303 411855173 FUNDRAISING MN 501(C)(3) 7 CENTRACARE HEALTH SYSTEM 0 CUSHMAN ALBERT RICE TRUST 1100 WEST ST GERMAIN STREET SAINT CLOUD MN 56303 416019335 SUPPORT FOR CARRIS HEALTH MN 501(C)(3) 12A, I CARRIS HEALTH 0 CARRIS HEALTH FOUNDATION 301 BECKER AVENUE SW WILLMAR MN 56201 411611555 SUPPORT FOR CARRIS HEALTH MN 501(C)(3) 7 CENTRACARE HEALTH FOUNDATION 0 MONTICELLO CANCER CENTER 1001 HART BOULEVARD SUITE 50 MONTICELLO MN 55362 261909519 RADIATION & ONCOLOGY SERVICES MN N/A 0 0 BENSON MEDICAL LLC 1228 ATLANTIC AVENUE BENSON MN 56215 203149203 HEALTHCARE MN N/A 0 0 CENTRACARE HOLDINGS INC 1406 6TH AVENUE NORTH SAINT CLOUD MN 56303 472688595 HOLDING COMPANY/PHARMACY MN N/A C 0 AFFILIATED COMMUNITY MEDICAL CENTERS PA 301 BECKER AVENUE SW WILLMAR MN 56201 410850702 HEALTH CARE SYSTEM MN N/A C 0 AFFILIATED COMMUNITY HEALTH NETWORK INC 101 WILLMAR AVENUE SW WILLMAR MN 56201 411765606 HEALTH NETWORK MN N/A C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 CENTRACARE HEALTH SYSTEM P 26777751 FMV CENTRACARE HEALTH FOUNDATION C 59216 FMV CENTRACARE HEALTH SYSTEM B 318260 FMV CENTRACARE HEALTH SYSTEM N 2390551 FMV CENTRACARE HEALTH SYSTEM O 4580425 FMV